宫腔镜下宫腔粘连电切术后再粘连发生的因素调查分析

目的:调查与分析宫腔镜下宫腔粘连电切术后再粘连发生的因素,为预防术后再粘连的发生提供参考。方法:2016年2月到2018年11月选择在本院诊治的宫腔粘连患者112例,所有患者都给予宫腔镜下宫腔粘连电切术治疗,调查患者的一般资料,随访患者术后再粘连发生情况并进行多因素调查分析。结果:所有患者都顺利完成手术,围手术期无严重并发症发生;术后随访调查12个月,术后再粘连发生18例,发生率为16.1%。在112例患者中,不同病情、人流次数、宫腔操作次数、性生活年龄、产次患者的术后再粘连率对比差异都有统计学意义(P0.05)。多因素logistic回归方程结果显示病情、人流次数、宫腔操作次数、性生活年龄为影响患者术后再粘连发生的主要因素(P0.05)。结论:宫腔镜下宫腔粘连电切术后再粘连比较常见,其病情、人流次数、宫腔操作次数、性生活年龄为影响患者术后再粘连发生的主要危险因素。因此,术后提高女性的生活习惯和避孕意识,是防范宫腔粘再连的根本措施。

Investigation and Analysis of Factors Affecting Adhesion Recurrence after Transcervical Resection of Adhesions

ABSTRACT Objective: To investigate and analysis the factors of adhesion recurrence after transcervical resection of adhesions, and to provide reference for prevention of postoperative adhesion recurrence. Methods: 112 patients with intrauterine adhesions were enrolled in our hospital from February 2016 to November 2018. All patients were treated with transcervical resection of adhesions. The general data of the patients and the adhesion recurrence occurred were investigated, and were given multi-factor investigation analysis. Results: All patients were underwent surgery successfully, and there were no serious complications occurred during the perioperative period. Followed up for 12 months, there were 18 patients were adhesion recurrence, and the incidences of postoperative adhesion recurrence were 16.1 %. Among the 112 patients, there were statistically significant differences in comparison of adhesion recurrence rates among patients with different illness, frequency of abortion, number of intrauterine operations, age of sexual life, and parity (P<0.05). The results of multivariate logistic regression equation showed that the illness, number of abortions, number of intrauterine operations, and age of sexual life were the main factors affected postoperative adhesion recurrence in patients (P<0.05). Conclusion: Re-adhesion are more common after hysteroscopic intrauterine adhesions. The severity of illness, number of abortions, number of intrauterine operations, and age of sexual life are the main factors affecting postoperative re-adhesion. Therefore, improving women''s living habits and contraceptive awareness after surgery is a fundamental measure to prevent uterine adhesions.